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Alcohol abstinence and risk assessment for second esophageal cancer in Japanese men after mucosectomy for early esophageal cancer

View Article: PubMed Central - PubMed

ABSTRACT

Background: Alcohol consumption combined with inactive aldehyde dehydrogenase-2 (ALDH2) and the presence of multiple esophageal Lugol-voiding lesions (LVLs; dysplasia) are strong predictors for multiple development of esophageal squamous cell carcinoma (ESCC) in East Asians. We invented a health risk appraisal (HRA) model for predicting the risk of ESCC based on drinking, smoking, dietary habits, and alcohol flushing, i.e., past or present facial flushing after drinking a glass of beer, a surrogate marker for inactive ALDH2.

Methods: Prospective follow-up examinations (median follow-up time, 50.3 months) were performed in 278 Japanese men after endoscopic mucosectomy for early ESCC (UMIN Clinical Trials Registry ID: UMIN000001676).

Results: Sixty-four subjects developed metachronous ESCC. A receiver operating characteristic curve showed that HRA scores ≥12 best predicted the development of metachronous ESCC. The ESCC detection rate per 100 person-years was 9.8 in the high-HRA-score group (n = 104) and 4.5 in the low-HRA-score group (n = 174), and the risk of development of metachronous ESCC was higher in the high-HRA-score group than in the low-HRA-score group (adjusted hazard ratio: 2.00 [95% CI: 1.12–3.30]). Multiple LVLs was a very strong predictor of the development of metachronous SCC, but high HRA scores predicted it independently. The cumulative incidences of metachronous ESCC decreased after drinking cessation in the high-HRA-score drinker group (adjusted hazard ratio: 0.37 [0.14–0.97]).

Conclusions: Both the HRA model that included alcohol flushing and the multiple LVL grade predicted the development of metachronous ESCC in Japanese men after endoscopic mucosectomy for ESCC. Drinking cessation in the high-HRA-score drinker group reduced the rate of metachronous ESCC.

No MeSH data available.


Related in: MedlinePlus

Time-dependent receiver operating characteristic curve according to HRA score at 24 months for predicting metachronous esophageal squamous cell carcinoma (SCC) in patients who had undergone endoscopic mucosectomy for early esophageal SCC.
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pone.0175182.g002: Time-dependent receiver operating characteristic curve according to HRA score at 24 months for predicting metachronous esophageal squamous cell carcinoma (SCC) in patients who had undergone endoscopic mucosectomy for early esophageal SCC.

Mentions: The median follow-up period was 50.3 months (range, 1.3–81.2 months), and 64 subjects were diagnosed with metachronous esophageal SCC. Fig 2 shows the time-dependent ROC curve of the HRA model for predicting having developed metachronous esophageal SCC at 24 months, because the data analysis was performed 24 months after the endoscopic mucosectomy for the first esophageal SCC of the most-recently registered subject. The sensitivity of this possible predictor increased with a relatively small increase in the false-positive rate above the HRA score cutoff point of 12, at which the sensitivity was 67.3% and the false-positive rate was 32.7%. We therefore used an HRA score cutoff point of ≥12 in the following analyses.


Alcohol abstinence and risk assessment for second esophageal cancer in Japanese men after mucosectomy for early esophageal cancer
Time-dependent receiver operating characteristic curve according to HRA score at 24 months for predicting metachronous esophageal squamous cell carcinoma (SCC) in patients who had undergone endoscopic mucosectomy for early esophageal SCC.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383267&req=5

pone.0175182.g002: Time-dependent receiver operating characteristic curve according to HRA score at 24 months for predicting metachronous esophageal squamous cell carcinoma (SCC) in patients who had undergone endoscopic mucosectomy for early esophageal SCC.
Mentions: The median follow-up period was 50.3 months (range, 1.3–81.2 months), and 64 subjects were diagnosed with metachronous esophageal SCC. Fig 2 shows the time-dependent ROC curve of the HRA model for predicting having developed metachronous esophageal SCC at 24 months, because the data analysis was performed 24 months after the endoscopic mucosectomy for the first esophageal SCC of the most-recently registered subject. The sensitivity of this possible predictor increased with a relatively small increase in the false-positive rate above the HRA score cutoff point of 12, at which the sensitivity was 67.3% and the false-positive rate was 32.7%. We therefore used an HRA score cutoff point of ≥12 in the following analyses.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Alcohol consumption combined with inactive aldehyde dehydrogenase-2 (ALDH2) and the presence of multiple esophageal Lugol-voiding lesions (LVLs; dysplasia) are strong predictors for multiple development of esophageal squamous cell carcinoma (ESCC) in East Asians. We invented a health risk appraisal (HRA) model for predicting the risk of ESCC based on drinking, smoking, dietary habits, and alcohol flushing, i.e., past or present facial flushing after drinking a glass of beer, a surrogate marker for inactive ALDH2.

Methods: Prospective follow-up examinations (median follow-up time, 50.3 months) were performed in 278 Japanese men after endoscopic mucosectomy for early ESCC (UMIN Clinical Trials Registry ID: UMIN000001676).

Results: Sixty-four subjects developed metachronous ESCC. A receiver operating characteristic curve showed that HRA scores ≥12 best predicted the development of metachronous ESCC. The ESCC detection rate per 100 person-years was 9.8 in the high-HRA-score group (n = 104) and 4.5 in the low-HRA-score group (n = 174), and the risk of development of metachronous ESCC was higher in the high-HRA-score group than in the low-HRA-score group (adjusted hazard ratio: 2.00 [95% CI: 1.12–3.30]). Multiple LVLs was a very strong predictor of the development of metachronous SCC, but high HRA scores predicted it independently. The cumulative incidences of metachronous ESCC decreased after drinking cessation in the high-HRA-score drinker group (adjusted hazard ratio: 0.37 [0.14–0.97]).

Conclusions: Both the HRA model that included alcohol flushing and the multiple LVL grade predicted the development of metachronous ESCC in Japanese men after endoscopic mucosectomy for ESCC. Drinking cessation in the high-HRA-score drinker group reduced the rate of metachronous ESCC.

No MeSH data available.


Related in: MedlinePlus